Using Big Data to Improve Health

In Louisville, Kentucky, 21 pharmacies act as gateways between patients and a new high-tech asthma inhaler equipped with a sensor to keep track of when and where it is used.

Each time the patient takes a puff, a sensor attached to the top of the inhaler transmits the user’s location to a Google Map-style website that patients and their doctors can access via a smart phone or computer. The site even has the local weather forecast and an icon that lets patients know how well they are managing their symptoms.

“Several different patients have said they didn’t before realize that their asthma was out of control. It really opened their eyes,” says Greg Baker, a pharmacy supervisor for Walgreens in Louisville that is handing out the free inhalers

It’s part of the one-year study by a Madison, Wisconsin-based startup company, Asthmapolis, which promises to help asthma sufferers and their doctors gain insight into what triggers symptoms and how best to reduce them.

The device, improved with Geographic Information Systems or GIS, could also help researchers understand asthma’s origins and triggers, says David Van Sickle, an epidemiologist who co-founded the company a few years ago out of frustration over the lack of solid, place-based information available to medical researchers trying to understand the uptick in asthma rates nationwide

The inhaler is one of a plethora of high tech new health gadgets, apps and websites—loosely referred to “geo-medicine” —that harness the “big data” more closely associated with stock trading and oil exploration. The results, proponents say, are poised to transform healthcare by giving patients more control over their healthcare decisions, their doctors better information for treating them and medical researchers bigger insights into some of the more pressing health questions of our time

Asthma afflicts one in every 12 people in the country and costs a total of $50 billion in medical bills each year. The Asthmapolis inhaler is just one example of the GIS mapping tools now available to help correlate health with local environmental conditions. Today, smart phone apps are emerging that can predict the likelihood that you’ll get cancer or heart disease; crunch medical data; and cross-reference your address history and map your lifetime pollution exposures. While epidemiologists, researchers and policy wonks have long used U.S. Census and other data to identify public health problems, the new tools promise to vastly expand the concept of medical history and make it easier for patients—as well as doctors—to better understand their health risks and make more informed health decisions

“That place and pollution matter is a no brainer. Everybody already knows this intellectually even though people are just starting to talk about it,” says Bill Davenhall, a healthcare manager for the GIS software developer Esri. Davenhall, a proponent of geo-medicine, says his epiphany came after he woke up in the hospital a decade ago after a heart attack and began to think about how industrial pollution and smog could have led to the attack that nearly killed him. Esri now offers its own free iPhone app that can cross-reference everywhere you’ve ever lived to the pollution exposures and attendant rates of heart disease and respiratory aliments.

Software developers have only turned their attention to geo-medicine in recent years, largely in response to two developments: the Obama administration’s “open government” policies that have made vast new datasets of Medicaid and Medicare information available, and federal healthcare reform that has boosted the health IT industry by placing more responsibility on healthcare providers to address growing lifestyle-related ailments such as obesity and diabetes.

That’s not to say the new data bonanza doesn’t pose a few new problems: Privacy experts say many of the new online apps collect personal information without offering sufficiently stringent policies on how the information may be used. That could put some individuals (say, those who have lived in particularly polluted places) at a disadvantage when it comes to applying for health insurance, says Kate Black, an attorney focusing on health privacy at the Center for Democracy & Technology in Washington, D.C. And, she adds, it could also fuel a public backlash against otherwise promising technologies.

“Because the field is so new, it’s still scary to a lot of people,” Black says. “But the federal government and companies are beginning to understand the need to address privacy.”

APPS CONNECTING HEALTH AND PLACE

Healthy Insights in Real-Time: An app developed by the University of Rochester. Similar to Google Flu Trends, it uses Twitter data to look for emerging health trends such as viral outbreaks.

Symcat: A free app that allows users to put in a number of symptoms and get diagnosed based on symptom scoring, epidemiological data and health trends.

Health Indicators: An iPad app from the geospatial software company, Critigen. It allows local policymakers to drill down to the county level and compare a variety of health and demographic data.